Child abuse can cause significant damage to a child’s mental and emotional well-being. Some studies have suggested that physical forms of abuse lead to more devastating effects than emotional forms of abuse, and consequences of abuse differ across sex and race. But a study published October 14 in JAMA Psychiatry is challenging these findings: it suggests that different forms of child maltreatment—whether physical, emotional, or neglectful—have strong and comparable consequences for boys and girls across racial and ethnic groups.

For the study, David Vachon, Ph.D., of McGill University in Montreal and colleagues analyzed data collected from 1986 to 2012 of nearly 2,300 children (aged 5 to13) who attended a weeklong summer camp program. The program for low-income children incorporated recreational activities and behavioral assessments. Children were assigned to small groups, according to their age, that included children who had been maltreated and those who had not.

At the end of the week, both the children and trained counselors (who were blinded to the children’s maltreatment status) provided reports on the behavioral characteristics of every child in the group. The reports were then compiled and analyzed.

Children who had experienced nonsexual maltreatment of any kind showed higher rates of a range of internalizing (depression and social withdrawal) and externalizing (aggression and fighting) behavior problems than nonmaltreated peers, and the problems grew worse in children with more frequent or more diverse maltreatment. The results were similar across race and gender.

“This is not to say that there are no differences between boys and girls,” Vachon toldPsychiatric News. “We know that across the board boys tend to externalize more and girls internalize more. The addition of abuse just bumps up all behavioral risks equally. So aggression and fighting will still be more prominent among boys, but their risks of depression or anxiety will increase as well.”

In terms of therapeutic implications, Vachon said he believes that the study highlights the importance of starting therapy early for children who have been abused.

“Abuse produces this starburst effect that alters so many parts of a developing brain; children’s self-esteem, their trust, their view of the world all alter drastically following abuse and that’s why you see these broad behavioral changes,” he said. “If maltreated children can be identified as close to the event as possible, then psychosocial therapy may be able to prevent the neurobiological changes that might predispose them to problems later in life.”

Of course, it would be best to prevent abuse from occurring in the first place, and that requires raising awareness about the dangers of emotional abuse—the most common form of child abuse. According to Vachon, the success of recent efforts to reduce bullying (a form of peer-to-peer emotional abuse) in schools demonstrates the way that raising awareness can lead to big changes.

“We just need to generate the same shift in attitude among parents, coaches, or other mentors who sometimes may think the occasional disparaging remark is no big deal, and let them know that it is.”

This study was supported by grants from the National Institute on Drug Abuse, National Institute of Mental Health, and the Spunk Fund Inc. ■

An abstract of “Assessment of the Harmful Psychiatric and Behavioral Effects of Different Forms of Child Maltreatment” can be accessed here.

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